With age, the spinal canal is a tunnel formed from vertebrae made up together and filled with a brain that undergoes changes. Sometimes this process can be accompanied by pain. Why does lumbar spinal stenosis develop? We will talk today about the causes of pathology, its diagnosis and methods of treatment.
The main symptoms and causes of the disease
Does your lower back hurt? Occurs repeated inflammation of the sciatic nerve? Feeling discomfort when walking, and sometimes problems with the sphincter? Similar symptoms may indicate spinal stenosis. This ailment is also called lumbar stenosis or cauda equina syndrome.
The spine consists of 33 stacked vertebrae. Between each vertebra is a cartilaginous disc, which limits the friction of articulated surfaces and absorbs shocks. Everything rests on the ligaments and tendons of the back muscles. The spinal canal of the spine is formed by holes in the vertebrae. On each side of the vertebrae there are small channels for the extraction of nerve roots. Part of the nerve fibers of the lumbar spine is a formation, which is called a horse tail.
With age, the spinal canal narrows in the lumbar region. The nerve roots of the cauda equina can be compressed by the shell that protects them. The same thing happens with blood vessels supplying nerve fibers. Thus, the nerves do not receive more blood and become damaged.
In 95% of cases, osteoarthritis is the cause of stenosis. The remaining 5% are presented by such reasons as:
- hypertrophied yellow ligaments in the arches of the vertebrae;
- intervertebral prolapse of discs or spinal hernia;
- hypertrophied facet joints;
- congenital pathology of the narrowed spinal canal;
- back injuries.
Spinal stenosis of the cervical spine is accompanied by symptoms very similar to the hernia. But unlike a hernia, stenosis is a chronic process with a slow evolution. Severe forms of cervical spinal stenosis are characterized by throbbing pain, especially with neck flexion, loss of sensation, general weakness, burning and pricking of the hands.
Patients with stenosis often suffer from pain in the buttocks, tingling in the thigh and leg in a standing position or when walking. Discomfort is relieved by leaning forward or crouching. In some cases, there are complaints of pain in the back and legs.
Absolute stenosis of the cervical spinal canal is almost always the cause of circulatory disorders, which is fraught with such serious consequences as paralysis of the lower extremities and dysfunction of the pelvic organs. Such patients need emergency surgical care.
Diagnosis and methods of treatment
Narrowing of the spinal canal is the most common indication for lumbar surgery in people over 65 years of age. That is why the correct diagnosis remains the most important step in treatment.
Radiography of the anterior and dynamic profile of the lumbar spine is appointed in case of constant pain. In this case, the patient is not relieved from simple medical treatment, which can eliminate other root causes of radiculopathy.
A scanner or MRI of the lumbar spine is prescribed in case of persistent pain, despite the use of analgesics. This allows visualization of the lumbar spinal canal and compression in the case of compression of the nerve root. Scanning the lumbar spine is the first line of research. It helps to accurately assess the changes between the various bone structures of the spine.
If there is no ponytail syndrome or severe functional impairment, the treatment of spinal stenosis in the lumbar region should be used as the first line of therapy. Medical treatment to reduce the intensity of pain includes the following measures:
- resting prone where appropriate;
- rehabilitation through physiotherapy;
- the use of painkillers and anti-inflammatory drugs;
- injections of corticosteroids in the periphery of the horse's tail;
- wearing lumbar support, hard corset, which limit lordosis.
Surgical treatment is preferred in case of significant disability and immediately, if there is functional impairment in the lower extremities, horsetail syndrome, which is an emergency. This decompression operation or decompression laminectomy is performed to widen the narrowed canal and / or release compressed nerve roots.
Surgery gives about 80% good results. Regression of lower back pain is slow, the effectiveness of the operation can actually be assessed after 4 to 6 months.
Methods of rehabilitation after surgery on the spine
There are several physiotherapeutic methods that are designed to help restore the patient's good physical condition after spinal surgery:
- Pain control after stenosis surgery. It is very difficult to complete a rehabilitation program if a person experiences severe pain. The challenge is to reduce the pain to a minimum with physiotherapy.
- Therapeutic exercise to strengthen the muscles of the back in the area of the incision and small muscles around the spine. This allows for a sufficient level of stabilization of the back and spinal protection.
- Exercises to recover from spinal surgery. Movement is vital - it is the key to eliminating fatigue, restoring normal activities, reducing the risk of re-injury.
The success of any patient in recovering from spinal surgery depends on his willingness to work hard on his own and with the therapist.
Stenosis is curable. Conservative treatment increases recovery time. But to perform the operation it is very important to take into account the presence of other disorders and the physical condition of the patient.